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Office of the Deputy

Director of Educaton,
MMR, Charni Road,
Application Form No. 350363 Application Version No. 0
Mumbai Application Form Version Date

11th Standard online Admission Application Form printed On 12 Jun 2017 - 11:50:31
2017-18, MMR Region
Application Form 12 Jun 2017 - 11:50:53 Application Form Version Updated By
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350363

(F.Y.J.C) -

Personal Details, Type of Candidature and Board Details of Applicant

Full Name SHAIKH AYAZ HASSAN Mother's Name RAZIA

Gender Male Date of Birth 17/04/2001

Board SSC Month & Year of Passing March 2017 Seat No./Roll No. A261310
ST.STANISLAUS HIGH SCHOOL, HILL RD, BANDRA,MUMBAI
Residence MMR 10th School Details
3201006
Address for Correspondence and Contact Details:
Correspondence Address:- 28 chapel road near duke restaurant, bandra west mumbai-400050 , , , andheri, mumbai, 400050
Phone No Mobile No 9819974026 Email Id shaikhmohsin30489@gmail.com
Reservation Details
Category General / Open Other category
Admission for Bifocal, MCVC (Technical Quota Admission)
Have you opted at SSC Exam any subject out of V1,V2,V3 or any Subject of NSQF (e.g./Multiskill, Retail, health and wellness etc.) No

Minority Quota Admission Inhouse Quota Admission

Do you belong to minority? Yes
Do you want to take admission in Inhouse Quota? No
Religious - Muslim
Required Documents & Status
Sr.No. Document Name Submitted Original Value New Value Status Date
1 Muslim Religion Certificate Yes -- -- Pending --
1. Following applicants MUST visit their respective School Principals/Guidance Center with printout of application form along with supporting Documents for verification &
approval
2. Unless and until the application form is approved, with the supporting document by respective School Principals/Guidance Center, you can not proceed to fill the option
form.
a. SSC board students of Reserved Categories' with or without claiming any Special Reservation'
b. SSC board Students of Open Category but claiming any Special REservation.
c. All other boards' (other than SSC) students.
d. All boards' (including SSC) students requesting any rectifications under grievances
3. All OMS and OMMR applicants MUST visit Guidance center with printout of application form along with supporting documents for verification & approval
Description:- I hereby declare that all information furnished by me in the online admission process is true, compelete and correct to the best of my knowledge and
belief. I understand that entire information furnished by me in this application is final and binding to me. Further, I understand that ,if any information furnished by me
in the Online Admission Process for standard XI, is found to be false or incorrect, i shall be liable for appropriate legal action and my admission will be cancelled as
per rules.

Place: Principal Signature:

Applicant Signature
Date: Prinicipal Name

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